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20 January 2011

Drinking four cups of coffee every day can decrease a woman's risk of developing Type 2 diabetes by more than half, according to a new study.

And the researchers say they've uncovered the reason why the new findings and other research have suggested a link between java and diabetes. They found that coffee raises the amount of sex hormone-binding globulin (SHBG) in the blood, and higher levels of SHBG are known to lower the risk of developing Type 2 diabetes.

It's likely something in the coffee besides the caffeine — or something about coffee drinkers that confers these protective effects, said James D. Lane, an associate research professor at Duke University Medical Center, who was not involved with the study.

Although, "it's impressive to find these new things," Lane told MyHealthNewsDaily, more research is needed to confirm the link.

The study is published in this month's issue of the journal Diabetes.

The more you drink, the lower your diabetes risk

In the new study, researchers from the University of California, Los Angeles, compared the medical histories and coffee-drinking habits of 359 women who had diabetes with those of 359 healthy women over 10 years. They used information from the Women's Health Study, run by the National Institutes of Health.

Women who drank four cups of caffeinated coffee a day had higher levels of SHBG and were 56 percent less likely to develop Type 2 diabetes than women who don't drink coffee, the researchers found.

And the more coffee the women drank, the more their risk of developing Type 2 diabetes dropped, the study said.

Furthermore, when the researchers took into account the women's SHBG levels, they found that it was coffee's effect on SHBG levels that was making the difference in diabetes risk. SHBG regulates the levels of sex hormones in the blood.

Previous work had suggested a link between SHBG and diabetes. A 2009 study in the New England Journal of Medicine, done by one of the researchers of the new study, showed that higher levels of SHBG in the blood were associated with a lower risk of developing Type 2 diabetes.

Past evidence of protection

A causal link between SHBG, diabetes and coffee — which contains many compounds — is not clear, Lane said. For example, he pointed to a 2004 study in journal Diabetes Care, which showed that caffeine is harmful to people with Type 2 diabetes, because it hinders the breakdown of glucose.

But other past studies have shown that something in coffee seems to have a protective effect against Type 2 diabetes, he said.

A 2006 study in the journal Archives of Internal Medicine of 28,812 women found that those who drank six cups of decaffeinated coffee a day had a 22 percent lower risk of developing Type 2 diabetes than those who don't drink any coffee. Caffeinated coffee also seemed to have a protective effect, though not as strong as that of decaffeinated coffee, the researchers said.

And a 2009 study in the same journal showed that each daily cup of coffee or tea cut the risk of developing diabetes by 7 percent.

A study published in Alternative Medicine Review shows that Meriva, an Indena proprietary formulation of curcumin with soy phospholipids, has been shown to relieve pain and increase mobility in patients with osteoarthritis as well as reduce a series of inflammatory markers.

In the study, 100 patients with X-ray confirmed osteoarthritis (OA) were divided in two groups. The first one was managed using the “best available treatment” and the second group used the best available treatment plus Meriva, at a dosage corresponding to 200 mg curcumin/day.

The results showed that the Meriva-treated group had a statistically significant reduction in all primary clinical end-points, the Western Ontario and McMaster Universities (WOMAC) score, the Karnofsky Performance Scale, and the treadmill walking performance test. These results were complemented by the evaluation of a series of inflammatory markers, soluble vascular cell adhesion molecule (sVCAM)-1, and erythrocyte sedimentation rate [ESR]), which also showed a marked reduction in the Meriva-treated group, while no significant variation was observed in the “best available treatment” group.

Commenting on the results of the study, Giovanni Appendino, Professor of Organic Chemistry at the University of Eastern Piedmont and Indena Scientific Advisor, said “this study represents the most ambitious attempt, to date, to evaluate the clinical efficacy and safety of curcumin as an anti-inflammatory agent. Although no direct comparison study of Meriva versus NSAIDs (nonsteroidal anti-inflammatory drugs) has been conducted, the decreased use of these drugs observed in the treatment group provides a rationale for evaluating whether the biochemical improvement in the inflammatory status associated with Meriva could eventually translate to a phase out of NSAIDs use, at least for mild-to-moderate OA.”

18 January 2011

Fever is common, but fever is complicated. It brings up science and emotion, comfort and calculation.

I know fever is a signal that the immune system is working well. And as a parent, I know there is something primal and frightening about a feverish child in the night.

So those middle-of-the-night calls from worried parents, so frequent in every pediatric practice, can be less than straightforward. A recent paper in The Journal of the American Medical Association pointed out one reason, and a longstanding discussion about parental perceptions reminds us of the emotional context.

The JAMA study looked at over-the-counter medications for children, including those marketed for treating pain and fever: how they are labeled, and whether the droppers and cups and marked spoons in the packages properly reflect the doses recommended on the labels.

The article concluded that many medications are not labeled clearly, that some provide no dosing instrument, and that the instruments, if included, are not marked consistently. (A dosing chart might recommend 1.5 milliliters, but the dropper has no “1.5 ml” mark.)

“Basically, the main message of the paper is that the instructions on the boxes and bottles of over-the-counter medications are really confusing,” said the lead author, Dr. H. Shonna Yin of New York University Medical Center, who is a colleague of mine and an assistant professor of pediatrics.

Too small a dose of an antipyretic (fever medicine) may be ineffective; too much can be toxic. But the dose depends on the child’s weight, which of course changes over time, and on the concentration of the medicine, which depends on whether it is acetaminophen or ibuprofen, children’s liquid or infant drops.

“We always make them get the bottle,” said Kathleen Martinez, a pediatric nurse practitioner who is clinical coordinator of the After Hours Telephone Care Program at the Children’s Hospital in Aurora, Colo. “What do you have at home? Is it the ibuprofen infant drops or the children’s? Have the bottle in hand and verify the concentration.

“And then we have to verify the instrument, and then we give the right dose based on weight. It’s time-consuming, and then of course it changes with the weight, so the poor parents have to call back.”

Concerns about fever — how worried should I be, and how much medicine should I give? — account for many of the calls that parents make at night to their children’s doctors. For me, these tricky measurement questions evoke memories of many conversations, often from a crowded, noisy place (my own child’s Little League game, the supermarket), trying to answer a question about a small child with fever.

One recent night, I talked to the mother of a toddler with fever and abdominal pain. I was more worried about the pain, and about whether he was drinking enough to stay hydrated; she was more worried about the fever, and no matter what I asked she kept coming back to that number on the thermometer.

Finally, I got so worried the child was dehydrated that I told her to go to the emergency room. And when she got there, she told them she was scared because the child had a high fever.

Fever can indeed be scary, and any fever in an infant younger than 3 months is cause for major concern because of the risk of serious bacterial infections. But in general, in older children who do not look very distressed, fever is positive evidence of an active immune system, revved up and helping an array of immunological processes work more effectively.

Of course, that may not be reassuring to a parent whose child’s temperature is spiking at midnight. (Fevers tend to go up in the late afternoon and evening, as do normal body temperatures.)

In 1980, Dr. Barton D. Schmitt, a professor of pediatrics at the University of Colorado School of Medicine, published a now classic article about what he termed “fever phobia.” Many parents, he wrote, believed that untreated fevers might rise to critical levels and that even moderate and low-grade fevers could have serious neurological effects (that is, as parents we tend to suspect that our children’s brains may melt).

A group at Johns Hopkins revisited Dr. Schmitt’s work in 2001, publishing a paper in the journal Pediatrics, “Fever Phobia Revisited: Have Parental Misconceptions About Fever Changed in 20 Years?” Their conclusion was that the fears and misconceptions persisted.

In fact, fever does not harm the brain or the body, though it does increase the need for fluids. And even untreated, fevers rarely rise higher than 104 or 105 degrees.

As many as 5 percent of children are at risk for seizures with fever. These seizures can be terrifying to watch but generally are not harmful and do not cause epilepsy. Still, a child who has a first febrile seizure should be checked by a physician. (These seizures tend to run in families, and children who have had one may well have another.)

“Parents are telling us that they’re worried that fever can cause brain damage or even death in their children,” said Dr. Michael Crocetti, an assistant professor of pediatrics at Johns Hopkins and lead author of the 2001 study. “I’ve been doing this for a long time, and it seems to me that even though I do a tremendous amount of education about fever, its role in illness, its benefit in illness, it doesn’t seem to be something they keep hold of from visit to visit.”

Dr. Janet Serwint, another author of the study and a professor of pediatrics at Johns Hopkins, agreed. “I personally think there should be much more education about this at well visits,” she told me, adding that parents need to understand “the helpfulness of fever — how fever actually is a well-orchestrated healthy response of our body.”

Other studies have looked at attitudes among medical personnel, who can be just as worried about fever as parents.

(Reuters) - People who have had a type of stroke caused by bleeding in the brain should avoid taking cholesterol-lowering drugs known as statins, U.S. researchers said on Monday.

Although statins are commonly used to prevent heart attacks and strokes, they said the drugs could increase the risks of a second stroke in these patients, outweighing any other heart benefits from the drugs.

"Our analysis indicates that in settings of high recurrent intracerebral hemorrhage risk, avoiding statin therapy may be preferred," Dr. Brandon Westover of Massachusetts General Hospital and Harvard Medical School and colleagues wrote in the Archives of Neurology.

That was especially true of people who had strokes in one of the brain's four lobes - frontal, parietal, temporal, or occipital - which recur more frequently than such strokes that occur deep in the brain.

Westover said people who have had this type of stroke have a 22 percent risk of a second stroke when they take statins, compared with a 14 percent risk in people who are not taking a statin.

The findings are based on a mathematical model based on data from two clinical trials.

The researchers said it is not clear how statins increase the bleeding risk in these patients. It may be having low cholesterol increases the risk of bleeding in the brain, or it may be that statins affect clotting factors in the blood that increase the risk of a brain hemorrhage in these patients.

Statins lower low-density lipoprotein or LDL, the bad kind of cholesterol that can lead to blood clots that increase the risk of heart attacks and strokes.

They are among the best-selling drugs in the world, fueled by many studies showing they reduce the risk of heart attacks and strokes.

Dr. Larry Goldstein of Duke University and Durham VA Medical Center in North Carolina said in a commentary the findings do not prove that statins increase the risk. But he said in the absence of high-quality clinical trial data, they may help doctors make better decisions about which patients with heart risks will benefit from taking statins.

Coronary heart disease is the leading cause of death in the United States, killing one in five adults.

Pfizer's Lipitor or atorvastatin has global sales of $11 billion a year while AstraZeneca's Crestor has global sales of more than $5 billion.

17 January 2011

Teenagers fond of too much of sugar in their diet are likely to face a higher heart attack risk as adults.

A study found that teens who consume elevated amounts of added sugars in drinks and foods are more likely to have poor cholesterol and triglyceride profiles which may lead to heart disease later in life.

It also found that overweight or obese teens with the highest levels of added sugar intake had increased signs of insulin resistance - a precursor to diabetes, the journal Circulation reports.

Added sugars are caloric sweeteners added to foods or beverages in the manufacturing process or by the consumer, according to the American Heart Association.

Adolescents are eating 20 percent of their daily calories in sugars that provide few if any other nutrients,` said Jean Welsh, study author and post-doctoral fellow in paediatric nutrition at Emory University School of Medicine, according to its release.

`We know from previous studies the biggest contributors of added sugars to the diet are sugar-sweetened beverages such as sodas, fruit-flavoured drinks, and sweetened coffees and teas.`

This is the first study to assess the association of added sugars and the indicators of heart disease risk in adolescents, Welsh says.

The National Health and Nutrition Survey of 2,157 teenagers (aged 12 to 18) found the average daily consumption of added sugars was 119 grams (28.3 teaspoons or 476 calories), accounting for 21.4 percent of their total energy.

They are the most widely produced fruit in the world and now scientists in Japan have discovered that tomatoes contain a nutrient which could tackle the onset of vascular diseases. The research, published in the journal Molecular Nutrition & Food Research, reveals that an extracted compound, 9-oxo-octadecadienoic, has anti-dyslipidemic affects.

The team led by Dr Teruo Kawada, from Kyoto University and supported by the Research and Development Program for New Bio-industry Initiatives, Japan, focused their research on extracts which tackle dyslipidemia, a condition which is caused by an abnormal amount of lipids, such as cholesterol or fat, in the blood stream.

"Dyslipidemia itself usually causes no symptoms," said Kawada, "however; it can lead to symptomatic vascular diseases, such as arteriosclerosis and cirrhosis. In order to prevent these diseases it is important to prevent an increased build up of lipids."

Tomato is already known to contain many compounds beneficial to health. In this study the team analyzed 9-oxo-octadecadienoic acid, to test its potential anti-dyslipidemia properties.

The compound was found to enhance fatty acid oxidation and contributed to the regulation of hepatic lipid metabolism. These findings suggest that 9-oxo-octadecadienoic acid has anti- dyslipidemia affects and can therefore help prevent vascular diseases.

"Finding a compound which helps the prevention of obesity-related chronic diseases in foodstuffs is a great advantage to tackling these diseases", concluded Kawada. "It means that the tomato allows people to easily manage the onset of dyslipidemia through their daily diet."